NPIMap

Individual provider Active NPI

Dennis E Smith Jr., D.O.

  • Family Medicine Physician
  • Tupelo, MS
National Provider Identifier
1245279918
Registry record updated Feb 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18803 Issued in MS
Practice address
1665 South Green St
Tupelo, MS 38804
Phone
(662) 377-2189
Fax
(662) 377-2263
NPI assigned
Jun 6, 2006
Last updated
Feb 12, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18803 MS Primary

Addresses

Primary practice location

1665 South Green St
Tupelo, MS 38804

Mailing address

450 E President Ave
Tupelo, MS 38801-5599
Phone (662) 377-4685

Other identifiers 1

IdentifierTypeStateIssuer
09014041MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061117000315 MS Practitioner - Family Practice 6406854959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City College of Medicine and Surgery, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Faculty Practice Plan LLCGroup PAC ID 2961658950, 8 clinicians

Practice addresses (Care Compare)

1665 S Green St
Tupelo, MS 38804-6556
Phone (662) 377-2189

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18803MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Faculty Practice Plan LLC Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center, Inc CurrentSince Sep 29, 2013 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Sep 29, 2013 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Family Medical Clinic of North Ms Inc Family Medicine PastSince Oct 1, 2001 Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients

Locations

1665 S Green St
Tupelo, MS 38804
Phone (662) 377-2189

450 E President Ave
Tupelo, MS 38801
Phone (662) 377-3204

4579 S Eason Blvd
Ste A
Tupelo, MS 38801
Phone (662) 377-6161

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: dennissmith@nmhs.medalliesdirect.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1245279918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E PRESIDENT AVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015599",
            "telephone_number": "662-377-4685",
            "fax_number": "662-377-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 SOUTH GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38804",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DENNIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014041",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.